title: Evaluation of a broad range real-time polymerase chain reaction (RT-PCR) assay for the diagnosis of septic synovitis in horses.
abstract: Septic synovitis is a potentially debilitating and life-threatening disorder in horses. We hypothesized that a universal bacterial real-time PCR (RT-PCR) assay would have improved sensitivity and decreased turn-around time for detection of bacteria in synovial fluid (SF) samples. Forty-eight SF samples were collected from 36 horses that presented to two referral institutions with suspected septic synovitis. Universal RT-PCR, bacterial culture and SF analysis were performed on all samples, and an interpretation on the sample being septic or not was derived by three board certified specialists from the history, clinical assessment and SF characteristics. RT-PCR results were compared to a composite standard comprised of positive culture and interpretation by all three specialists of samples as "septic". For 41 of 48 samples (85%), culture and RT-PCR results were concordant. Compared to the composite standard, 83% of samples were correctly classified by RT-PCR (turn-around time of approximately 4 hours). Relative sensitivity and specificity of RT-PCR were 87% and 72% respectively, and 56% and 86% for culture. Hence, universal RT-PCR was a rapid and highly sensitive test, which may accelerate diagnosis and improve outcome for horses with septic synovitis.
authors.affiliation: Department of Clinical Studies (Elmas, Koenig, Cribb); Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario (Weese, Bienzle); Department of Diagnostic Medicine and Pathobiology, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, United States (Cernicchiaro); and Milton Equine Hospital, Campbellville, Ontario (Coté).
authors.forename: Colette R
authors.initials: CR
authors.lastname: Elmas
authors.forename: Judith B
authors.initials: JB
authors.lastname: Koenig
authors.forename: Dorothee
authors.initials: D
authors.lastname: Bienzle
authors.forename: Nicola C
authors.initials: NC
authors.lastname: Cribb
authors.forename: Natalia
authors.initials: N
authors.lastname: Cernicchiaro
authors.forename: Nathalie M
authors.initials: NM
authors.lastname: Coté
authors.forename: J Scott
authors.initials: JS
authors.lastname: Weese
mesh_terms: D000818:Animals; D001419:Bacteria / Q000235:genetics / Q000302:isolation & purification*; D016009:Chi-Square Distribution; D004269:DNA, Bacterial / Q000737:chemistry / Q000235:genetics; D006734:Horse Diseases / Q000175:diagnosis / Q000382:microbiology*; D006736:Horses; D057230:Limit of Detection; D012336:RNA, Ribosomal, 16S / Q000737:chemistry / Q000235:genetics; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods / Q000592:standards / Q000662:veterinary*; D012680:Sensitivity and Specificity; D013582:Synovial Fluid / Q000166:cytology / Q000382:microbiology*; D013585:Synovitis / Q000175:diagnosis / Q000382:microbiology / Q000662:veterinary*
chemical_list: D004269:DNA, Bacterial; D012336:RNA, Ribosomal, 16S